Nosocomial Urinary Tract Infections in Children

Authors: Ayse BALAT, L. Leighton HILL

Abstract: Nosocomial infections are a major cause of morbidity and mortality in hospitalized children, and the urinary tract is one of the most common sites of these infections. We retrospectively reviewed the charts of 1,221 children discharged with a diagnosis of urinary tract infection (UTI) from July 1, 1991 to June 30, 1994. Of the 1,221 UTIs, there were 137 (11.2%) cases of nosocomial UTI (NUTI) in 136 patients. NUTI accounted for 0.28% of all discharges (48, 382 patients) at a single institution over the 3-year period studied. There were 75 girls and 61 boys. The mean age was 4.4 years old. The peak occurrence of NUTI was in patients younger than 1 year old and in girls more than 3 years to 11 years old and more than 11 years to 18 years (P<0.05). Fever was the most common symptom (82.5%). Ninety-three (67.9%) of the 137 NUTIs identified occurred in catheterized patients. Fifty (30.3%) of the 165 causative organisms isolated were Escherichia coli. Of the patients with NUTI, 22.6% had cardiologic diseases, 19.7% had neurological diseases, and 13.9% had malignant diseases. The rate of bacteremia was 8.8%. NUTI appeared to be associated with some predisposing factors such as younger age, urinary tract catheterization, and the severity of disease.

Keywords: Nosocomial, urinary tract infection.

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